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ATLANTA -- Those in cardiovascular medicine can anticipate changes in clinical practice for acute myocardial infarction (MI) following this weekend's American College of Cardiology (ACC) annual conference, the first time the meeting is returning to Atlanta since 2010.

ACC's 3 days of scientific and educational sessions will be held in-person starting on Saturday, April 6th, with some sessions also available streamed online.

Notably, the conventional wisdom of giving heart attack survivors long-term beta-blockers for secondary prevention is in the hot seat.

During a Sunday-late breaker session at ACC, investigators will release results comparing composite rates of death of any cause or recurrent MI between beta-blocker and no-beta-blocker groups among patients with an acute MI and preserved left ventricular ejection fraction.

Skeptics have long argued that the evidence for beta blockade is outdated, coming from a time before early reperfusion, statins, and antithrombotics. If beta-blockers do not show a benefit in REDUCE-AMI's contemporary setting, with roughly 5,000 participants, it may signal a need to change longstanding guidelines that have endorsed this class of drugs for MI indefinitely, regardless of left ventricular function.

Other data on acute MI at ACC will address whether heart attack survivors are helped by the SGLT2 inhibitor empagliflozin (Jardiance) in the trial. This trial also had approximately 5,000 people, judged to be at high risk for subsequent heart failure or mortality, randomized to empagliflozin 10 mg or placebo daily in addition to standard of care within 14 days of hospital admission for MI.

In addition, the AEGIS-II team will paint a fuller picture of how infusions of CSL112, a version of cholesterol efflux mediator apolipoprotein A-I, after acute MI -- indirectly also dealing a blow to the already-beleaguered hypothesis that higher HDL cholesterol prevents heart disease. The large trial had over 18,000 people randomized to receive four weekly doses of CSL112 or placebo initiated within 5 days of first medical contact.

Also relevant to acute MI are the on chelation therapy and the report on intravascular ultrasound-guided percutaneous coronary intervention (PCI) as compared against angiographic guidance.

Other scientific reports that are anticipated at ACC include:

• - Trial testing safety and effectiveness of the V-Wave intra-atrial shunt for heart failure
• - Head-to-head trial comparing self-expanding vs balloon-expandable transcatheter aortic valve replacement systems for people with small aortic annuli, typically women, who had been excluded from the landmark trials
• - Impella transvalvular micro-axial pump tested in infarct-related cardiogenic shock
• - Trial testing a coronary sinus reduction device for refractory angina
• - Comparison of preventive PCI or medical therapy alone for atherosclerotic coronary vulnerable plaques that are not yet obstructive in flow

Additionally, the meeting is welcoming leaders from related cardiovascular societies for a joint society session discussing ongoing efforts to create a new Board of Cardiovascular Medicine through the American Board of Medical 番茄社区. This session will be held Saturday morning.

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